American College of Surgeons
Southwestern Pennsylvania Chapter 

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  • April 09, 2020 11:08 AM | Jim Ireland (Administrator)

    MOST INTERESTING CASE PRESENTATIONS

    ELIGIBILITY 
    The competition is open to all general surgery residents and surgical specialty residents. Medical students are not eligible. Having presented at the national level is not a disqualifier to submitting an abstract.

    Send two copies of each abstract to be presented (one blind copy with only the paper’s title for judging and one version with the principal author’s name, institution, phone, and e-mail address) to the SW PA Chapter Office by Friday, May 1st, 2020  The abstracts will be reviewed with a number being selected for presentation at the May 27th event.  Each selected presenter will be notified shortly thereafter. 

    Presentations will be judged by a panel of surgeons with cash prizes awarded to the top three “Most Interesting Cases.”  1st Place $500, 2nd Place $300, 3rd Place $200

    The “Most Interesting” case will be submitted for publication in the ACS Case Reviews in Surgery.

    The recently launched ACS Case Reviews in Surgery (ACS Case Reviews) publishes case reports in various surgical specialties six times a year. The content of each case report should be something of interest to practicing surgeons and describe experiences that may not be routinely seen or was treated in a unique fashion. Case reports that involve patients who have common surgical problems—where the clinical presentation and/or challenges of management produced knowledge and insights that have educational value—are also worthy of submission to ACS Case Reviews. Case reports will be reviewed with the understanding that the work has not been published by, and is not under consideration at, any other journal. All manuscripts are peer reviewed.

    As per submission guidelines, residents can submit to ACS Case Reviews if an ACS Fellow is included as one of the case report authors. Chapters would judge submitted entries and the winner of the competition would receive guaranteed review of the publication in ACS Case Reviews and a free one-year subscription to the journal (annual subscriptions are $125 with CME and $75 without CME).

    SPECIFICATIONS FOR PREPARATION AND SUBMISSION OF ABSTRACTS

    • The abstract should be no more than one page (approximately 500 words) and provide adequate information and objective data to evaluate the abstract properly.
    • The abstract should be submitted electronically, preferably as a Word document or PDF. It is permissible to single-space the abstract.
    • At the top of the first page, the full title of the abstract and full name of the principal author, with academic degrees, are to be stated.
    • At the bottom of the first page, a footnote should be included to provide the principal author’s mailing address, telephone number, and e-mail address. This contact information is very important.
    • A short video can be included as part of your submission
    • Abstracts not submitted in this manner will not be accepted

    The details of the May 27th Chapter meeting are still to be determined.  The event may be virtual depending upon the state of COVID-19.  Those whose abstracts are selected will be provided with details regarding the presentation of their abstract at the Chapter meeting.

    Abstracts are to be submitted to MIC2020@acms.org.  Any questions, please contact Jim Ireland at 412/321-5030 or jireland@acms.org.


    Download the guidelines


  • April 08, 2020 10:52 AM | Jim Ireland (Administrator)

    In anticipation that the COVID-19 crisis will continue to escalate throughout the U.S., Operation Giving Back has devised a plan to collect names of available volunteers, identify their skill sets, and map this information where it may be used for rendering medical assistance in areas of need. If you are willing to volunteer in any capacity, please take the COVID-19: How Can I Help? survey and we will contact you if your skill set(s) match the needs for potential opportunities. Do not hesitate to let us know areas of acute need that may arise in your area as well.

    As you may know, many states have recognized the need for additional aide and have called on volunteer health care professionals to serve in their communities during this unprecedented time. As a result, licenses have been expedited and temporarily reinstated, telehealth policies have loosened, and state volunteer portals have been created to streamline workforce reentry, to list a few. We encourage you to review ACS’s COVID-19 State Volunteer Resources page  to learn where you are able to implement your skill sets based on these temporary policy changes.

  • April 02, 2020 1:50 PM | Jim Ireland (Administrator)

    The ACS wants to hear how COVID-19 is impacting you, both professionally and personally. Share your story or experience to help ensure the College can continue to advocate on your behalf. And spread the word via social media. To amplify access to our information, the College has registered #ACSCOVID19 with Symplur Healthcare Hashtags. Use #ACSCOVID19 in all social media messages and to link those messages to ACS communications.

  • March 30, 2020 11:28 AM | Jim Ireland (Administrator)

    This week, the American College of Surgeons issued guidelines on triage of patients undergoing elective cancer surgery during the COVID-19 pandemic.

    During the current COVID-19 pandemic, hospital leadership and individual providers are facing increasingly difficult decisions about how to conserve critical resources, such as hospital and intensive care unit (ICU) beds, respirators, and transfusion capacity, as well as protective gear (PPE) that is vital for protecting patients and staff from unnecessary exposure and intrahospital transmission. While nothing will replace sound medical judgement and local adjudication, it has generally been advised that hospitals discontinue elective surgery, and guidance on the triage of nonemergent surgical procedures during the pandemic is available. Guidance on the triage of elective surgery is based on an Elective Surgery Acuity Scale provided by Sameer Siddiqui, MD, FACS, of St. Louis University.

    Triage guidelines contained herewith add another level of specificity on triage of elective cancer surgery patients during the COVID-19 pandemic. This information is intended to help institutions and providers who are facing a rising burden of hospitalized COVID-19 patients and a higher prevalence of community infection. Not all cancer conditions can be outlined; this document will focus on how to manage the more common cancer types during the pandemic. 

    Read complete article

  • March 30, 2020 11:27 AM | Jim Ireland (Administrator)

    In addition to the Bulletin: ACS COVID-19 newsletter we are sending to members, we are also rapidly sharing information related to your practice as we have it. To that end, the ACS Washington team has identified information regarding the Coronavirus Aid, Relief, and Economic Security (CARES) Act, signed into law on Friday, that provides some pathways for physicians to obtain financial assistance for their practices. We know many of you want to apply for this assistance if you are experiencing financial strains on your practice related to COVID-19. 
     
    First, the Centers for Medicare and Medicare Services (CMS) has recently expanded the Accelerated and Advanced Payment Program. Surgeons and others may request advanced Medicare payments to address cash flow issues based on historical payments. More information about this program can be found here and here.
     
    In addition, relief for small businesses, including those run by physicians, was included in the $2 trillion CARES Act legislation. The provisions include the appropriation of $562 million for Economic Injury Disaster Loans to ensure that the Small Business Administration (SBA) has adequate resources to assist businesses in need.
     
    The SBA’s Economic Injury Disaster Loan program provides small businesses with working capital loans of up to $2 million that can provide vital economic support designed to help overcome the temporary loss of revenue. In response to the COVID-19 pandemic, small business owners in all fifty states, Washington, DC, and U.S. territories are eligible to apply.
     
    The CARES Act clarified that eligibility would be for those businesses of 500 employees or less at each business location.
     
    Fellows may learn more about Economic Injury Disaster Loans and find the appropriate applications here.
     
    ACS continues to support all our surgeons who are serving their communities in the COVID-19 crisis and curtailing their normal clinical practices. ACS continues to remind the White House, Congress, the Department of Health and Human Services and CMS to support our surgeons so that when we recover from COVID-19, our surgical practices will recover, too. 
     
    Christian Shalgian
    Director, Division of Advocacy and Health Policy (DAHP) 

    Patrick V. Bailey, MD, FACS
    Medical Director,  Advocacy, DAHP

    Frank Opelka, MD, FACS
    Medical Director, Quality and Health Policy, DAHP

    David B. Hoyt, MD, FACS
    Executive Director, ACS

  • March 26, 2020 12:53 PM | Jim Ireland (Administrator)

    The American College of Surgeons website is constantly being updated with useful resources to help us deal with personal and professional challenges in this trying time. Visit facs.org/COVID-19.
     
    Members are receiving the twice-weekly Bulletin: ACS COVID-19 Updates newsletter from the Executive Leadership of the College. 
     
    RAS-ACS is organizing weekly "hangouts" to allow a forum for students, trainees, and young surgeons to share stories, best practices from our institutions, and to have an opportunity to just connect with each other and have a support network, as we deal with these new challenges. Information about how to connect will be posted in our newsletter, Twitter and Facebook pages. 
     
    Given the disruption to education and training, we are also organizing weekly educational sessions for students and residents. The schedule can be found online and make sure to check @RASACS on Twitter for content updates. 

  • March 23, 2020 1:50 PM | Jim Ireland (Administrator)

    It is important to be prepared for the potential need to operate on a Coronavirus Disease 2019 (COVID-19) person under investigation (PUI) or a COVID-19 patient. Preparation of a specific operating room (OR) and detailed education of the entire OR team who will be providing care for these patients during their procedure is imperative, without using stock protective equipment. The specific roles and responsibilities of all OR team members must be clear, with a common goal of minimizing the spread of infection to health care workers.

    • Develop a dedicated COVID-19 OR to control the spread of the disease
    • Empty OR of all nonessential materials
    • Consider a negative pressure anteroom with separate access if possible
    • Anteroom is used for donning/doffing of personal protective equipment (PPE) and separate OR carts for the COVID-19 OR
    • Separate OR airway cart; specific airway guidelines for COVID-19 PUI/confirmed patients
    • Separate OR equipment cart
    • Separate OR medication cart
    • Runner outside OR for drugs, devices, equipment
    • If intubation required for OR procedure, recommend intubation in negative pressure room prior to OR; avoid intubation in OR
    • Use dedicated transport ventilator if being transported on mechanical ventilation (ambulatory bag with viral filter, if ventilator unavailable)
    • Additional heat and moisture exchange (HME) filter and viral filter on expiratory limb of anesthesia machine circuit
    • Consider additional viral filter on expiratory limb of anesthesia machine circuit
    • Minimize airway circuit disconnection, endotracheal tube (ETT) must be clamped if any circuit disconnection planned
    • Special PPE for OR (N95 or OR powered air-purifying respirator (PAPR), goggles or face shield, gown, boot covers)
    • Provide appropriate PPE education (CDC guidance copied below) and post in anteroom in OR
    • Must use N95 or OR PAPR for all aerosol-generating procedures
    • Extubation should occur in a negative pressure intensive care unit (ICU)/ward room if possible
    • Recover patient in the negative pressure ICU/ward room or in the dedicated COVID-19 OR if negative pressure room not available
    • Consider dedicated OR teams to manage COVID-19 patients in the OR with detailed education
    • Consider performing procedures in negative pressure rooms with anesthesia team support if possible

    Following are links to infographics from other sources that offer additional salient details:


  • March 23, 2020 1:48 PM | Jim Ireland (Administrator)

    Short answer: Place high-quality viral filters between the breathing circuit and the patient’s airway and between the expiratory limb and the machine. The use of these filters is essential to prevent contamination of the machine. (See previous article for details on which filtration devices to use). Note: Even with filters, breathing circuits should be discarded after every patient.

    The anesthesia machine needs to be protected from contamination by a potentially infected patient for two reasons. First, if pathogens can enter the internal parts of the machine, they could be passed on to a subsequent patient. Second, respiratory gases sampled for gas analysis can pass pathogens on to other patients or health care professionals after leaving the gas analyzer if improperly managed.

    The good news is that the same precautions can be applied to all patients. The strategy is the same regardless of the patient’s risk of infection. A high-quality filter placed between the breathing circuit and the patient’s airway will protect the machine from contamination and also filter gas sampled for analysis. Heat and moisture exchange filters (HMEFs) are a good choice because they preserve airway humidity and are designed so that sampled gas is filtered before it enters the gas analyzer. It is possible to use a filter at the airway that is not also an HMEF. If a filter only is used, lower fresh gas flows (1-2 L/min or less) are desirable during maintenance of anesthesia to preserve humidity in the circuit.

    It is also recommended to add an effective viral filter between the expiratory limb of the circle system and the machine. Not only is this second filter a reasonable backup to protect the machine from any particles that pass the primary filter, but it significantly amplifies the effectiveness of the first filter. Given the fact that the primary filter can become less effective if soiled, the backup filter is a good recommendation. Another filter between the machine and the inspiratory limb is added sometimes but is not necessary to protect the machine from the patient nor to protect the patient if the machine is kept clean. The main reason to add an inspiratory limb filter is to eliminate the chance of error by placing a single filtered limb on the inspiratory rather than expiratory port.


    More Resources

  • March 18, 2020 10:08 AM | Jim Ireland (Administrator)

    Book mark https://www.facs.org/about-acs/covid-19 and check back for updates.


    About the Coronavirus Disease 2019 (COVID-19)

    Updated March 17, 2020

    COVID-19 Update: Guidance for Triage of Non-Emergent Surgical Procedures

    ACS has issued guidance for triage of non-emergent surgical procedures during the COVID-19 pandemic.

     Read the entire document online

    Posted March 17, 2020

    COVID-19 Update: Elective Surgery

    ACS has issued recommendations on the management of elective surgical procedures during the COVID-19 pandemic.

     Read the entire document online

    Posted March 13, 2020


  • February 18, 2020 11:06 AM | Jim Ireland (Administrator)

    Participants in this coding workshop will not only learn how to correctly report surgical procedures and medical services, but will also have access to the tools necessary to succeed, including coding workbooks to keep for future reference that include exercises, checklists, resource guides, templates, and examples. Physicians receive up to 6.5 AMA PRA Category 1 Credits for each day of participation. In addition, each day of the workshop meets AAPC guidelines for 6.5 continuing education units. 

    Register Today

    Thursday Course: Office Procedures and E/M Coding 
    At the end of this session, participants will be able to:

    • NEW! Recognize the E/M office visit changes for 2021
    • Demonstrate accurate coding of E/M office and hospital visits in 2020
    • Identify appropriate use of modifiers with E/M services
    • Describe the components of the global surgical package, including critical care rules
    • Demonstrate coding for screening versus diagnostic colonoscopy
    • Apply teaching physician rules and coding for services
    • Describe accurate coding of telemedicine, eVisits, consults, and non-face-to-face services
    • Implement practice management strategies for collecting from patients with high-deductible health plans. 

    Friday Course: 2020 Successful Surgical Coding 
    At the end of this session, participants will be able to:

    • Distinguish different categories of codes and how payment differs
    • Describe what is included in a global surgical package and what can be reported separately 
    • Distinguish what surgical modifier to report 
    • Describe documentation requirements for unlisted codes 
    • Demonstrate correct coding and documentation for radiology services
    • Describe coding for different surgical approaches 
    • Identify when to report mesh and reinforcement implants
    • Demonstrate correct coding for a variety of general surgery procedures



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